By Vicki Lebsack

Bipolar disorder, one of the most severe mental illnesses, frequently goes unrecognized and untreated, despite the availability of effective diagnostic and treatment methods.

"It's common for bipolar disorder to go unrecognized for 10 years," said Novia Anderson MSW, LCSW, program director for Senior Bridges, Northern Nevada Medical Center's psychiatric program specializing in older adults' behavioral health needs.

An illness characterized by extreme highs and lows, bipolar disorder often may be diagnosed only as depression. "Individuals with the disease may be more prone to seeking help in the depressive phase of the illness because they are having difficulty carrying out daily routines," Anderson said. "Some don't view the manic stage during which they feel energized, alert and supercharged as a problem and may not report manic symptoms to their caregivers." As a result, people with bipolar disorder may be treated with antidepressants instead of mood stabilizers.

"Individuals, family members and physicians need to be on the lookout for warning signs that bipolar disorder has been overlooked, such as when the patient is not responding to treatment with antidepressants or is having increasing restlessness, irritability, insomnia and anxiety," said Anderson.

Besides being mistaken for depression, bipolar disorder also may be mistaken for anxiety disorder, borderline personality disorder or schizophrenia. Addictions to alcohol and other drugs also can cloud diagnosis and treatment since substance abuse is common among individuals with bipolar disorder.

Whenever a person exhibits signs of mania in addition to depression, he or she should undergo a full clinical evaluation with a mental health professional for bipolar disorder.

During the manic stages of the illness, people experience:

• Increased energy, activity and restlessness
• An unusual, almost "magical," feeling of happiness
• Extreme irritability
• Racing thoughts and talking very fast, jumping from one idea to another
• Distractibility, inability to concentrate
• Little sleep needed
• Unrealistic beliefs in one's abilities and powers
• Spending sprees
• Provocative, intrusive or aggressive behavior
• Increased sexual drive
• Abuse of drugs, particularly cocaine, alcohol and sleeping medications
• Denial that anything is wrong

In the down or depressive stage of the illness, people experience:

• Lasting sad or empty mood
• Feelings of hopelessness or pessimism
• Feelings of guilt, worthlessness or helplessness
• Loss of interest or pleasure in activities once enjoyed, including sex
• Decreased energy, feeling tired or slowed down
• Difficulty concentrating, remembering, making decisions
• Eating or sleeping too much or too little
• Thoughts of death or suicide

Doctors use medication to treat bipolar disorder. Counseling also helps individuals and their family members understand and overcome the emotional, physical and social effects of the disease.

Vicki Lebsack, Senior Bridges Community Education Manager

Vicki Lebsack is community education manager for Senior Bridges at Northern Nevada Medical Center. Senior Bridges offers inpatient and outpatient medical and psychiatric support for adults 55 and older who are experiencing depression, anxiety or other mental health challenges. For more information, please call Senior Bridges at 356-4071.

Northern Nevada Medical Center 2375 E. Prater Way, Sparks, NV 89434 775-331-7000